BMJ 2002;324:1095 ( 4 May )

Letters

Mortality and volume of cases in paediatric cardiac surgery

    Paper confirms poor quality of paediatric heart surgery at Bristol during 1991-5
    Volunteered mortality data may be unreliable

Paper confirms poor quality of paediatric heart surgery at Bristol during 1991-5

The first 150 words of the full text of this article appear below.

EDITOR---Spiegelhalter's paper represents further statistical evidence confirming the poor quality of paediatric open heart surgery at Bristol Royal Infirmary during 1991-5.1 It finally lays to rest the argument that the low number of operations was the only contributory factor to the high death rates.2 Spiegelhalter confirms that low numbers contributed to between 12% and 17% of the excess mortality observed at Bristol Royal Infirmary. When his findings are coupled with an article confirming that Bristol was an outlier in terms of its performance as a paediatric cardiac surgical centre at this time, the justification for attempting to obtain a review of the service seems incontrovertible.3

The conclusions of the Hunter/de Leval inquiry are difficult to understand in this context unless there was some interference in the processes of the inquiry by the management of Bristol Royal Infirmary, as there was in the publication of favourable articles in the . . . [Full text of this article]
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Relevant Article

Mortality and volume of cases in paediatric cardiac surgery: retrospective study based on routinely collected data
David J Spiegelhalter
BMJ 2002 324: 261. [Abstract] [Full Text] [PDF]

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